The Obamacare bailout battle

The latest Republican attack on Obamacare is powerful and simple: “no insurer bailouts.”

But never fear, Democrats are ready with a response: “Well, that’s not really what it is. The provision in question is actually called ‘risk corridors,’ which is a mechanism for compensating health insurers in case their actual costs are at least 3 percent higher than their projected costs. But it’s only temporary, until they get better data on who their customers are. And if their costs are lower than they expected, they actually pay the government. And besides … ”

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The last thing Democrats want to do, with a law as complicated and full of moving parts as the Affordable Care Act, is explain what the law actually does.

And yet, they’re going to have to come up with something to answer the Republicans’ latest line of attack. The program that’s causing all the trouble is supposed to help insurers get through the first few years of Obamacare if their costs are higher than they thought. And it’s not an emergency measure — it was built into the law all along.

But the “insurer bailout” charge is already lighting fires on conservative talk radio, and if House Republicans move ahead with plans to attach a repeal of the provision to the next debt ceiling increase, the charge could draw attention way beyond the conservative base — even if the repeal ultimately gets stripped out.

The debate got another showcase on Wednesday, when Florida Sen. Marco Rubio — one of the main Republicans making the charge —was the star witness at House Oversight and Government Reform Committee Chairman Darrell Issa’s hearing, “Obamacare: Why the Need for an Insurance Company Bailout?”

“It’s time for the president and Secretary [Kathleen] Sebelius and for Obamacare supporters to level with taxpayers about the fact that their hard-earned tax dollars will soon be needed to bailout the Obamacare exchanges,” Rubio told the panel.

It’s a strategic problem that’s going to plague Democrats every time a fight flares up over a complicated part of the law. The website was actually a simple problem, as embarrassing as it was for the Obama administration: broken website, fix it. But when the fight moves on to the most complicated mechanisms in the law, the Democrats know they’ll lose the argument if they get drawn into the weeds.

It’s the perfect illustration of the problem Democratic Sen. Al Franken of Minnesota captured when Congress was debating the law in 2010: “Our bumper sticker has — it’s just way too many words. And it says, ‘Continued on next bumper sticker.’”

Or, as Democratic strategist Chris Kofinis puts it now: “If you get into the weeds of things, you’re dead.”

The Democrats actually got some good news on Tuesday that could help: The Congressional Budget Office said the provision will save the government $8 billion, not cost money. That’s because the money can flow both ways. If insurers priced their premiums too high, and their costs are lower than they thought, they pay the government.

But rather than get into a big explanation of all of that, Democrats are more likely to hit the Republicans back with a couple of catchier political points: If you take this out, premiums will rise and it will be your fault.

And by the way, you put the same thing in Medicare Part D, and you didn’t complain about it then.

“They were for risk corridors before they were against them,” said Drew Hammill, a spokesman for House Minority Leader Nancy Pelosi.

Top Democrats are already making use of the one-two punch.

“Republicans are attacking a program they have supported in the past that is specifically designed to stabilize the insurance market and keep costs down for families,” Senate Budget Committee Chairwoman Patty Murray said in a statement to POLITICO. “Repealing this program would disrupt coverage for millions of Americans who have now gained it thanks to the Affordable Care Act, and would punish families across the country with more uncertainty and higher prices.”

So is the risk corridors program really a “bailout” for insurers? It’s more like a “shock absorber,” as health care experts put it — a three-year program that will cushion the blow for health plans because of all the uncertainty about their costs.

At the moment, though, there’s no absolute guarantee that it won’t cost the government money in the short term, or that the costs have to balance out over the long run. In fact, before Tuesday’s CBO report, some analysts worried that the risk has increased since President Barack Obama allowed health insurers to extend policyholders’ pre-Obamacare health plans, because that’s likely to throw off the insurers’ calculations of their costs even more.

Obama administration officials, however, insist they’re going to implement it in a way that doesn’t cost money in the long term. The provision “was estimated to be budget neutral, and we intend to implement it as designed,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services.